中国药物警戒 ›› 2025, Vol. 22 ›› Issue (5): 507-512.
DOI: 10.19803/j.1672-8629.20250025

• 中药抗感染作用机制研究专栏 • 上一篇    下一篇

中药治疗感染后咳嗽的临床用药规律与安全性分析

解子乐1,2, 王成祥2,*, 胡彦鹏3, 李磊4, 崔鹤蓉5   

  1. 1北京中医药大学第三临床医学院,北京 100029;
    2北京中医药大学第三附属医院呼吸科,北京 100029;
    3北京中医药大学针灸推拿学院,北京 100029;
    4北京中医药大学第三附属医院感染性疾病科,北京 100029;
    5北京中医药大学生命科学院,北京 100029
  • 收稿日期:2025-01-10 出版日期:2025-05-15 发布日期:2025-05-19
  • 通讯作者: *王成祥,男,博士,教授,主任医师,中医内科学。E-mail:wang601@vip.sina.com
  • 作者简介:解子乐,女,在读硕士,医师,中医内科学。
  • 基金资助:
    国家自然科学基金资助项目(82201428、82074389)

Clinical Medications and Safety Analysis of Traditional Chinese Medicine for Post-Infection Cough

XIE Ziyue1,2, WANG Chengxiang2,*, HU Yanpeng3, LI Lei4, CUI Herong5   

  1. 1The Third Clinical Medical College of Beijing University of Chinese Medicine, Beijing 100029, China;
    2Department of Respiratory Medicine, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China;
    3School of Acupuncture and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China;
    4Department of Infectious Diseases, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China;
    5School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China
  • Received:2025-01-10 Online:2025-05-15 Published:2025-05-19

摘要: 目的 分析中药治疗感染后咳嗽(PIC)的用药规律及安全性。方法 收集并筛选2022年10月12日至2024年5月22日北京中医药大学第三附属医院呼吸科门诊PIC病例,通过古今医案云平台(V2.3.7)进行频次、关联规则及复杂网络分析,研究治疗PIC的药物频次、剂量、药性、药对配伍、核心处方等,结合文献评价其安全性。结果 共纳入PIC患者227例,涉及诊疗记录365次、处方365份、中药146种、总用药5 915次。高频药物为半夏、苦杏仁、甘草等,四气以温、平、寒为主,五味以苦、辛、甘为主,归经集中于肺、脾、胃经。关联规则显示干姜-五味子(共同出现254次)、半夏-苦杏仁(共同出现249次)等13对高频药对。提取治疗PIC的核心处方由半夏、干姜、苦杏仁、紫菀、百部、甘草、白前、黄芩、桔梗、薏苡仁、茯苓、五味子、葶苈子、蝉蜕14味中药组成。处方总剂量集中在100~299 g(94.79%),处方的药味数以15~19味为主(76.16%)。安全性评价结果显示中药治疗PIC不良反应发生率低。结论 中药治疗PIC重在止咳化痰,兼以“宣、降、敛、泻、清、补”,安全性较好,剂量精准把控是临床用药的关键。

关键词: 感染后咳嗽, 中药组方规律, 干姜-五味子, 剂量, 不良反应, 复杂网络分析

Abstract: Objective To analyze the prescription patterns and safety of traditional Chinese medicine (TCM) in treating post-infection cough (PIC). Methods The clinical data of PIC cases treated in the Respiratory Department of Beijing University of Chinese Medicine Third Affiliated Hospital between October 12, 2022 and May 22, 2024 was retrieved and screened. Frequency statistics, association rules, and complex network analyses were performed using the Ancient and Modern Medical Case Cloud Platform (V2.3.7) to investigate medication patterns, involving frequency, dosage, medicinal properties, herbal pair compatibility, and core prescriptions. The safety of these medications was evaluated via literature review. Results A total of 227 PIC patients were included, involving 365 medical records, 365 prescriptions, 146 herbs, and the total number of times herbal drugs were used was 5 915. Frequently-used herbs included Banxia (Pinelliae Rhizoma), Kuxingren (Armeniacae Semen Amarum), and Gancao (Glycyrrhizae Radix et Rhizoma. Medicinal properties were predominantly warm, neutral and cold, flavors were bitter, pungent, and sweet, and meridian tropisms focused on the lung, spleen, and stomach. Association rules identified 13 frequently-used herbal pairs-Ganjiang (Zingiberis Rhizoma)-WuweiZi (Schisandrae Chinensis Fructus) (co-occurrence count: 254) and Banxia-Kuxingren (249). The core prescription for PIC comprised 14 herbs: Banxia, Ganjiang, Kuxingren, Ziwan (Asteris Radix), Baibu (Stemonae Radix), Gancao, Baiqian (Cynanchi Stauntonii Rhizoma), Huangqin (Scutellariae Radix), Jiegeng (Platycodonis Radix), Yiyiren (Coicis Semen), Fuling (Poria), WuweiZi, Tinglizi (Descurainiae Semen), and Chantui (Cicadae Periostracum). Prescription dosages primarily ranged from 100 to 299 g (94.79%), with 15 to 19 herbs per prescription (76.16%). Safety evaluation indicated a low incidence of adverse reactions. Conclusion TCM treatments for PIC focus on resolving phlegm and suppressing cough while integrating strategies of dispersing, descending, astringing, draining, clearing, and tonifying. Its safety profile is favorable, and precise dosage control is critical to minimizing risks.

Key words: Post-Infection Cough, TCM Prescription Patterns, Ganjiang-WuweiZi, Dosage, Adverse Reactions, Complex Network Analysis

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